7 Common Burning Mouth Syndrome Symptoms You Should Know

Burning mouth syndrome (BMS) is a chronic pain condition characterized by a burning sensation in the mouth without an obvious cause. This puzzling disorder can affect the tongue, gums, lips, cheeks, palate, or widespread areas of the mouth. The discomfort can be severe and may persist for months or years, significantly impacting quality of life. While the exact cause remains unclear in many cases, understanding the symptoms is crucial for early recognition and proper management.

People with burning mouth syndrome often describe the sensation as similar to having scalded their mouth with hot liquid, yet there is no visible sign of injury or irritation. The condition typically affects middle-aged and older adults, with women being more commonly affected than men, especially after menopause. Let’s explore the key symptoms that characterize this challenging condition.

1. Intense Burning or Scalding Sensation

The hallmark symptom of burning mouth syndrome is a persistent burning or scalding sensation in the mouth. This uncomfortable feeling typically affects the tongue but can occur anywhere in the oral cavity, including the lips, gums, roof of the mouth, or inside the cheeks.

The burning sensation can vary in intensity throughout the day. Many patients report that the discomfort is minimal or absent upon waking but gradually increases as the day progresses, reaching peak intensity by evening. Others experience constant, unrelenting burning from the moment they wake up.

What makes this symptom particularly distressing is that the burning feels very real and intense, yet examination of the mouth typically reveals no visible abnormalities, redness, or lesions. The pain can be severe enough to interfere with eating, drinking, and speaking, significantly affecting daily activities and overall well-being.

2. Altered Taste Perception

Many individuals with burning mouth syndrome experience significant changes in their sense of taste, a condition known as dysgeusia. This alteration can manifest in several ways, making eating and drinking less enjoyable and sometimes even unpleasant.

Common taste changes include a persistent metallic taste in the mouth, bitter taste, or an overall diminished ability to taste foods properly. Some people report that foods they once enjoyed now taste completely different or bland. Sweet foods might taste less sweet, while others might detect an ongoing salty or sour taste even when not eating.

These taste disturbances can persist throughout the day and may worsen the burning sensation. The altered taste perception often leads to reduced appetite and changes in dietary habits, as patients may avoid certain foods that now taste unpleasant or amplify their symptoms.

3. Dry Mouth Sensation

Xerostomia, or the sensation of dry mouth, is a frequent companion to burning mouth syndrome. Patients often complain that their mouth feels parched and uncomfortable, as if they haven’t had enough water to drink, even when saliva production is actually normal.

This dryness can make speaking difficult, as the tongue may stick to the roof of the mouth or teeth. Swallowing can become uncomfortable, and many patients feel the need to sip water constantly throughout the day. The dry sensation may be particularly bothersome at night, disrupting sleep.

Interestingly, clinical examination and saliva flow tests often show normal or even increased saliva production in BMS patients, suggesting that the dry mouth sensation is more of a perceived symptom rather than an actual decrease in saliva. However, this doesn’t make the discomfort any less real for those experiencing it. The combination of burning and dryness can create a particularly uncomfortable experience that affects eating, speaking, and overall oral comfort.

4. Tingling or Numbness in the Mouth

Along with burning, many people with burning mouth syndrome experience abnormal sensations such as tingling, prickling, or numbness in the oral cavity. These sensations are often described as similar to the feeling you get when your foot “falls asleep” or when dental anesthesia is wearing off.

The tingling sensation typically affects the tongue, particularly the tip and sides, but can extend to the lips and other areas of the mouth. Some patients describe it as a “pins and needles” feeling that comes and goes, while others experience it as a constant background sensation accompanying the burning.

In some cases, the affected areas may feel numb or less sensitive to touch and temperature. This can create an odd contrast where the mouth simultaneously feels like it’s burning while also feeling somewhat numb. These contradictory sensations can be confusing and distressing, adding to the complexity of the condition and making it difficult for patients to accurately describe their experience to healthcare providers.

5. Increased Thirst

People with burning mouth syndrome frequently experience excessive thirst, medically known as polydipsia. This symptom often develops as a response to the burning sensation and the feeling of dry mouth, driving patients to drink fluids almost continuously throughout the day.

The increased thirst can be so pronounced that patients keep water bottles with them at all times and wake up multiple times during the night to drink. Despite consuming large amounts of fluids, the relief is usually temporary, and the burning and dry sensations quickly return.

This constant need to sip liquids can disrupt daily activities, social interactions, and sleep patterns. Some patients find slight temporary relief from the burning when drinking cold water or sucking on ice chips, which may provide a brief cooling sensation. However, this relief is short-lived, and the underlying symptoms persist. The cycle of burning, drinking, temporary relief, and returning symptoms can become exhausting and frustrating for those dealing with this condition.

6. Pain That Worsens Throughout the Day

A distinctive characteristic of burning mouth syndrome is the pattern of symptom progression throughout the day. Unlike many pain conditions that may be worse in the morning or remain constant, BMS typically follows a pattern where discomfort increases as the day goes on.

Many patients report waking up symptom-free or with minimal discomfort. As morning progresses into afternoon and evening, the burning sensation gradually intensifies, often becoming most severe in the late afternoon and evening hours. By bedtime, the pain may be at its peak, making it difficult to fall asleep.

This predictable pattern can help distinguish burning mouth syndrome from other oral conditions. However, it’s important to note that not all patients follow this exact pattern. Some experience constant symptoms from morning until night, while others may have fluctuating symptoms without a clear daily pattern. The progressive worsening throughout the day, when present, can significantly impact work productivity, social activities, and evening relaxation, as patients anticipate the increasing discomfort as the day advances.

7. Symptoms That Improve While Eating or Drinking

An interesting and somewhat paradoxical feature of burning mouth syndrome is that symptoms often temporarily improve or completely disappear while eating or drinking. This stands in contrast to many other oral conditions, where eating or drinking might aggravate pain or discomfort.

Patients frequently report that the burning sensation decreases or vanishes entirely when they’re actively chewing food or sipping beverages. This temporary relief can last for the duration of the meal or snack, only to return shortly after finishing. Cold foods and beverages may provide more noticeable relief than warm or hot items.

This characteristic leads some patients to eat or drink more frequently than necessary, not out of hunger or thirst, but seeking relief from the burning sensation. While this might provide short-term comfort, it can lead to unwanted weight gain or other dietary concerns. Some patients also find relief from chewing sugar-free gum or sucking on hard candies, which keeps the mouth active and may distract from the burning sensation. Understanding this pattern can be helpful for both diagnosis and developing coping strategies, though it’s important to maintain a balanced diet rather than constantly eating solely for symptom relief.

What Causes Burning Mouth Syndrome?

Burning mouth syndrome is classified into two types: primary (idiopathic) and secondary BMS. Primary BMS has no identifiable cause and is believed to be related to nerve damage or dysfunction affecting the nerves that control taste and pain in the mouth. Secondary BMS results from underlying medical conditions or factors.

Primary causes may include:

• Nerve damage: Damage to the nerves controlling taste and pain sensation in the tongue and mouth
• Hormonal changes: Particularly in postmenopausal women due to decreased estrogen levels
• Psychological factors: Anxiety, depression, and stress may play a role in symptom development or intensity

Secondary causes may include:

• Nutritional deficiencies: Low levels of iron, zinc, folate, thiamine, riboflavin, pyridoxine, or vitamin B12
• Oral conditions: Oral thrush (fungal infection), geographic tongue, oral lichen planus, or dry mouth from various causes
• Dentures: Ill-fitting dentures or allergic reactions to denture materials
• Medications: Certain blood pressure medications, particularly ACE inhibitors, can cause or worsen symptoms
• Systemic diseases: Diabetes, thyroid disorders, acid reflux, Sjögren’s syndrome, or other autoimmune conditions
• Allergies: Food allergies, reactions to dental products, or sensitivity to certain food flavorings or additives
• Habits: Excessive mouth irritation from over-brushing, overuse of mouthwashes, or tongue thrusting

Identifying the underlying cause is essential for appropriate management, which is why a thorough evaluation by healthcare professionals is important for anyone experiencing these symptoms.

Prevention Strategies

While primary burning mouth syndrome cannot always be prevented due to its unclear origins, there are several strategies that may help reduce the risk of developing the condition or prevent secondary BMS:

Maintain good oral hygiene: Brush teeth gently twice daily with a soft-bristled toothbrush and use alcohol-free mouthwash to avoid irritating the mouth. Avoid over-brushing or using abrasive toothpastes that might irritate oral tissues.

Ensure proper nutrition: Maintain a balanced diet rich in vitamins and minerals, particularly B vitamins, iron, and zinc. Consider having your healthcare provider check for nutritional deficiencies if you’re at risk.

Manage stress and mental health: Practice stress-reduction techniques such as meditation, yoga, or deep breathing exercises. Seek professional help for anxiety or depression, as these conditions may contribute to or worsen BMS symptoms.

Avoid irritants: Limit consumption of spicy, acidic, or very hot foods and beverages. Avoid tobacco products and excessive alcohol consumption, which can irritate oral tissues. Be cautious with cinnamon-flavored products, as some people are sensitive to this flavoring.

Stay hydrated: Drink adequate water throughout the day to maintain moisture in the mouth and support overall oral health.

Regular dental care: Visit your dentist regularly for check-ups and ensure dentures fit properly if you wear them. Address any dental problems promptly, such as infections or poorly fitting dental appliances.

Manage underlying conditions: Work with your healthcare provider to control chronic conditions like diabetes, thyroid disorders, or acid reflux that might contribute to oral symptoms.

Review medications: Talk to your doctor about medications you’re taking, as some can cause dry mouth or burning sensations. Don’t stop medications without medical advice, but discuss alternatives if needed.

Frequently Asked Questions

How long does burning mouth syndrome last?

Burning mouth syndrome can be a chronic condition lasting months to years. Some people experience spontaneous remission, while others have persistent symptoms. The duration varies greatly between individuals, and symptoms may fluctuate in intensity over time.

Can burning mouth syndrome go away on its own?

Yes, in some cases burning mouth syndrome resolves spontaneously without treatment, though this is unpredictable. Secondary BMS caused by an underlying condition often improves when that condition is addressed. However, many people require ongoing management strategies to control symptoms.

Is burning mouth syndrome a sign of cancer?

No, burning mouth syndrome itself is not a sign of oral cancer. However, persistent mouth pain or burning should always be evaluated by a healthcare professional to rule out other conditions, including cancer. A proper examination can help distinguish BMS from other serious conditions.

Does burning mouth syndrome affect only the tongue?

No, while the tongue is the most commonly affected area (especially the tip and sides), burning mouth syndrome can affect any part of the mouth, including the lips, gums, palate, throat, and inside of the cheeks. Some people experience burning in multiple areas simultaneously.

Can stress make burning mouth syndrome worse?

Yes, stress and anxiety can intensify burning mouth syndrome symptoms. Many patients report that their symptoms worsen during periods of high stress. Managing stress through relaxation techniques, counseling, or other methods may help reduce symptom severity.

Should I see a doctor for burning mouth syndrome?

Yes, if you experience persistent burning sensations in your mouth lasting more than a few days or weeks, you should consult a healthcare provider. A dentist, primary care physician, or oral medicine specialist can evaluate your symptoms, rule out other conditions, and help identify potential causes or contributing factors.

Can certain foods trigger burning mouth syndrome?

While foods don’t typically cause burning mouth syndrome, certain foods can worsen symptoms in people who already have the condition. Spicy, acidic, or hot temperature foods and beverages commonly aggravate symptoms. Some people also react to cinnamon, mint, or citrus flavors. Keeping a food diary can help identify personal triggers.

Is burning mouth syndrome more common in women?

Yes, burning mouth syndrome is significantly more common in women than men, particularly in postmenopausal women. The condition most frequently affects people over age 60, and hormonal changes associated with menopause are believed to play a role in many cases.

References:

• Mayo Clinic – Burning Mouth Syndrome
• National Institute of Dental and Craniofacial Research – Burning Mouth Syndrome
• Johns Hopkins Medicine – Burning Mouth Syndrome
• National Center for Biotechnology Information – Burning Mouth Syndrome
• American Academy of Family Physicians – Burning Mouth Syndrome